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Methods of assessment of selenium status in humans: a systematic review^1,2,3,4,5

¹ From the School of Medicine, Health Policy and Practice, the University of East Anglia, Norwich, United Kingdom (KA, LH, LJH, RH, AC, SJF-T); PenTAG, Peninsula Medical School, Universities of Plymouth and Exeter, Exeter, United Kingdom (KA); and the Institute of Food Research, Norwich Research Park, Colney, Norwich, United Kingdom (LJH).

² Presented at the EURRECA workshop "Biomarkers of Micronutrient Status," held in Sveti Stefan, Montenegro, 9 June 2008.

³ This manuscript does not necessarily reflect the views of the Commission of the European Communities and in no way anticipates their future policy in this area.

⁴ Partially supported by the Commission of the European Communities, specific RTD Programme "Quality of Life and Management of Living Resources," within the 6th Framework Programme (contract no. FP6-036196-2 EURRECA: EURopean micronutrient RECommendations Aligned).

⁵ Address correspondence to SJ Fairweather-Tait, School of Medicine, Health Policy and Practice, University of East Anglia, Norwich NR4 7TJ, United Kingdom. E-mail: s.fairweather-tait{at}uea.ac.uk.

Background: To understand the effect of selenium intake on health, it is important to identify sensitive and population-specific biomarkers of selenium status.

Objective: The objective of this systematic review was to assess the usefulness of biomarkers of selenium status in humans.

Design: The methods included a structured search strategy on Ovid MEDLINE, EMBASE (Ovid), and Cochrane databases; formal inclusion and exclusion criteria; data extraction into an Access database; validity assessment; and meta-analysis.

Results: The data from 18 selenium supplementation studies (of which 9 were randomized controlled trials and 1 was considered to be at low risk of bias) indicate that plasma, erythrocyte, and whole-blood selenium, plasma selenoprotein P, and plasma, platelet, and whole-blood glutathione peroxidase activity respond to changes in selenium intake. Although there is a substantial body of data for plasma selenium, more large, high-quality, randomized controlled trials are needed for this biomarker, as well as for the other biomarkers, to explore the reasons for heterogeneity in response to selenium supplementation. There was insufficient evidence to assess the usefulness of other potential biomarkers of selenium status, including urinary selenium, plasma triiodothyroxine:thyroxine ratio, plasma thyroxine, plasma total homocysteine, hair and toenail selenium, erythrocyte, and muscle glutathione peroxidase activity.

Conclusions: For all potentially useful biomarkers, more information is needed to evaluate their strengths and limitations in different population groups, including the effects of varying intakes, the duration of intervention, baseline selenium status, and possible confounding effects of genotype.

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